Análisis etiológico de las cefaleas desde un servicio de emergencia pediátrica / Analysis of the aetiologies of headaches in a paediatric emergency service

Introducción. La cefalea en los niños motiva frecuentes consultas en los diferentes servicios asistenciales; el perfil epidemiológico es muy diferente según la muestra proceda de consultorios ambulatorios o neuropediátricos, o de servicios de urgencia. Objetivo. Analizar las etiologías de las cefaleas desde un servicio de urgencias pediátrico. Pacientes y métodos. Se analizaron retrospectivamente las historias clínicas con cefaleas como principal motivo de consulta durante un período de seis meses en el Departamento de Emergencia Pediátrica del Centro Hospitalario Pereira Rossell. Se clasificaron las etiologías en función de los criterios de la Sociedad Internacional de Cefaleas (SIC), y se completó la información por vía telefónica cuando los registros médicos fueron insuficientes. Resultados. Se incluyeron 185 niños, que representaban el 0,58 por ciento de las consultas. Las etiologías más frecuentes fueron las infecciones no craneales (43,1 por ciento), las migrañas (14,6 por ciento), las cefaleas tensionales (9,2 por ciento), las traumáticas (8,1 por ciento) y la sinusitis (5,4 por ciento). Las causas graves representaron el 4,9 por ciento, con un predominio de tumores e infecciones del sistema nervioso central. El bajo porcentaje de meningitis virales en nuestra serie (1 por ciento) nos hace sospechar un subdiagnóstico de esta afección, dado el bajo número de casos en los que se estudió el líquido cefalorraquídeo. Conclusiones. Se confirma un perfil etiológico amplio y variado de las cefaleas en las emergencias, con un claro predominio de afecciones extracraneales y un bajo porcentaje de causas graves intracraneales. Las cefaleas no clasificables supusieron el 10,8 por ciento de la muestra. Se realizó estudio de imagen del cráneo en un 9,7 por ciento de los casos, porcentaje sensiblemente menor que en otras series, lo que evidencia un uso racional de este recurso (AU)

Introduction. Headaches are a frequent cause of children’s visits to different health care services but the epidemiological profile varies widely according to whether the sample is taken from among visits to hospital clinics, neuropaediatric units or emergency services. Aims. The aim of this study was to analyse the aetiologies of the cases of headache attended in a paediatric emergency service. Patients and methods. We conducted a retrospective analysis of patient records with headache as the main reason for visiting over a six month period at the Paediatric Emergency Department at the Centro Hospitalario Pereira Rossell. Aetiologies were classified according to International Headache Society (IHS) criteria and the information was completed by telephone if the medical records contained insufficient data. Results. The records of 185 children were studied, which represented 0.58% of the total number of visits. The most common aetiologies were non-cranial infections (43.1%), migraines (14.6%), tension-type headaches (9.2%), traumatic injury (8.1%) and sinusitis (5.4%). Serious causes constituted 4.9% of the total, with a predominance of tumours and infections of the central nervous system. The low percentage of viral meningitis in our series (1%) leads us to suspect an underdiagnosis of this disorder, given the scant number of cases in which the cerebrospinal fluid was examined. Conclusions. Our study confirmed the existence of a wide and varied range of aetiologies causing headaches, with a clear predominance of extracranial disorders and a low percentage of serious intracranial causes. Non-classifiable headaches made up 10.8% of the sample. Brain imaging studies were performed in 9.7% of cases, which is a considerably lower percentage than that of other series and demonstrates a rational use of this resource (AU)

[Analysis of the aetiologies of headaches in a paediatric emergency service]. / Análisis etiológico de las cefaleas desde un servicio de emergencia pediátrica.

INTRODUCTION: Headaches are a frequent cause of children's visits to different health care services but the epidemiological profile varies widely according to whether the sample is taken from among visits to hospital clinics, neuropaediatric units or emergency services. AIMS: The aim of this study was to analyse the aetiologies of the cases of headache attended in a paediatric emergency service. PATIENTS AND METHODS: We conducted a retrospective analysis of patient records with headache as the main reason for visiting over a six month period at the Paediatric Emergency Department at the Centro Hospitalario Pereira Rossell. Aetiologies were classified according to International Headache Society (IHS) criteria and the information was completed by telephone if the medical records contained insufficient data. RESULTS: The records of 185 children were studied, which represented 0.58% of the total number of visits. The most common aetiologies were non-cranial infections (43.1%), migraines (14.6%), tension-type headaches (9.2%), traumatic injury (8.1%) and sinusitis (5.4%). Serious causes constituted 4.9% of the total, with a predominance of tumours and infections of the central nervous system. The low percentage of viral meningitis in our series (1%) leads us to suspect an underdiagnosis of this disorder, given the scant number of cases in which the cerebrospinal fluid was examined. CONCLUSIONS: Our study confirmed the existence of a wide and varied range of aetiologies causing headaches, with a clear predominance of extracranial disorders and a low percentage of serious intracranial causes. Non-classifiable headaches made up 10.8% of the sample. Brain imaging studies were performed in 9.7% of cases, which is a considerably lower percentage than that of other series and demonstrates a rational use of this resource.